A nurse is caring for a client with severe hypothyroidism. Which of the following complications should the nurse monitor for?
Diabetic ketoacidosis
Myxedema coma
Thyroid storm
Addisonian crisis
The Correct Answer is B
A. Diabetic ketoacidosis: Diabetic ketoacidosis results from insulin deficiency and is associated with type 1 diabetes mellitus or severe insulin deficiency states. Hypothyroidism does not directly impair insulin metabolism to the extent required to precipitate ketoacidosis. The pathophysiology of these conditions is unrelated.
B. Myxedema coma: Severe hypothyroidism can progress to myxedema coma, a life-threatening emergency characterized by hypothermia, bradycardia, hypotension, hypoventilation, and altered mental status. It often occurs in older adults or after stressors such as infection or cold exposure. Early recognition is critical due to high mortality.
C. Thyroid storm: Thyroid storm is a complication of severe hyperthyroidism rather than hypothyroidism. It involves excessive thyroid hormone activity with hyperthermia, tachycardia, and agitation. This condition represents the opposite end of the thyroid dysfunction spectrum.
D. Addisonian crisis: Addisonian crisis is associated with acute adrenal insufficiency and cortisol deficiency. While autoimmune conditions can coexist, severe hypothyroidism alone does not directly cause adrenal crisis. Monitoring focuses on thyroid-related complications instead.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Activated partial thromboplastin time (aPTT): aPTT is used to monitor unfractionated heparin therapy, not warfarin. It measures the intrinsic and common coagulation pathways and does not reflect the anticoagulant effect of warfarin.
B. Bleeding time: Bleeding time assesses platelet function rather than coagulation factor activity. It is not useful for monitoring warfarin therapy and does not indicate therapeutic anticoagulation.
C. Hemoglobin (Hb): Hemoglobin levels indicate oxygen-carrying capacity and can reflect blood loss, but they do not provide information about anticoagulation status. Monitoring Hb alone is insufficient for warfarin therapy management.
D. Prothrombin time (PT/INR): PT, often expressed as INR, measures the extrinsic coagulation pathway, which is affected by warfarin’s inhibition of vitamin K–dependent clotting factors. Regular monitoring ensures therapeutic anticoagulation while minimizing the risk of bleeding complications.
Correct Answer is D
Explanation
A. Iron deficiency: Iron deficiency anemia does not alter urinary mineral concentration or urine volume in a way that promotes stone formation. It is not associated with calcium, oxalate, or uric acid stone development.
B. Obesity: Obesity is associated with metabolic changes that can increase stone risk, but it is a contributing factor rather than a direct precipitating condition. It does not affect urine concentration as immediately as fluid imbalance.
C. Protein in the urine: Proteinuria reflects kidney damage or glomerular disease rather than stone formation. While some renal disorders coexist with calculi, protein in the urine itself does not promote crystallization.
D. Dehydration: Low fluid intake leads to concentrated urine, increasing supersaturation of calcium, oxalate, and uric acid. This environment promotes crystal formation and is a primary, modifiable risk factor for renal calculi.
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